2006 Log Cabin - Illinois Membership Form
Please print this page, complete and mail this form to: Log Cabin Republicans - Illinois Attn: Treasurer 3712 N Broadway #136 Chicago, Illinois 60613
Please make all checks payable to: Log Cabin Republicans -Illinois.
Name(s)_________________________________________________________
Address_________________________________________________________
City,State,Zip____________________________________________________
Phone___________________________________________________________
Email___________________________________________________________
Voting Membership Levels (circle one)
- General Membership: $65-$249
- Bronze Level Donor: $250-$499
- All of the benefits of General Members
- A lapel pin indicating Bronze level support
- Listed as Bronze Level Donor in the LCR-Illinois Annual Dinner program
- One reserved seat at the LCR-Illinois Annual Dinner
- Silver Level Donor: $500-$999
- All of the benefits of General Members
- A lapel pin indicating Silver level support
- Listed as Silver Level Donor in the LCR- Illinois Annual Dinner program
- Two reserved seats at the LCR-Illinois Annual Dinner
- Gold Level Donor: $1,000-$2499
- All of the benefits of General Members
- A lapel pin indicating Gold level support
- Listed as Gold Level Donor in the LCR-Illinois Annual Dinner program
- Four reserved seats at the LCR-Illinois Annual Dinner
- Special Guest recognition at the LCR-Illinois Annual Dinner
- Platinum Level Donor: $2,500+
- All of the benefits of General Members
- A lapel pin indicating Platinum level support
- Listed as Platinum Level Donor in the LCR-Illinois Annual Dinner program
- One reserved table (8 seats) at the LCR- Illinois Annual Dinner
- Special Guest recognition at the LCR- Illinois Annual Dinner
- VIP reception with the Board of Directors (and special guests) prior to the LCR- Illinois Annual Dinner
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